Day: 11/26/2014

4/25/2014, The enemy at home: Veterans addicted and dying from VA pain pills

http://www.wthr.com/story/25336980/2014/04/24/the-enemy-at-home-veterans-addicted-dying-from-va-pain-pills

Facebook comments:

Aaron Bachstein:  Yup. And now I sit here in agonizing pain because people wouldn’t take their medications as directed or knew when to talk to their doctor. I just got off the phone with the Medical Director at my local VA Clinic and was told that they will “look into alternate methods but we cannot help you otherwise.”

Jacqueline Conley:  VA is hurting the veterans who really need them, my husband got cut down to 60 a month and it’s so funny that out source surgeons say he need operation but not VA, years of passing him doctor to doctor and VA to VA we been to them all!!! So I wonder if the people who decided to cuts medicine for those who really need it, if they have time to come do my yard work and change my oil????

I am a Veteran of the Vietnam War Era.
I go to Roudebush VA Hospital for all of my medical care.
My vertebrae between my belt and my tailbone are collapsed, causing a lot of pain.
My Primary Care Physician prescribed 6 Hydrocodone 5 per day. My back still hurt.
I begged to go to the Pain Clinic, which I had heard was so wonderful. It literally took months to get referred there.
So what was my total experience at the Pain Clinic?
Pharmacist Kelly Henderson reduced my prescription for Hydrocodone from 6 pills a day down to 2 pills a day!
My pain is much worse now. I can’t hardly do anything. I have to walk with a cane to help my back pain.
There are those who abuse Hydrocodone, and there are those that need it.
I wish I had never gone to the Pain Clinic. It has ruined my life.
A private Doctor screwed up a surgery on my wife’s neck, causing her to be in the Hospital for 9 Months and 20 days with a tracheostomy and a feeding tube. She can’t swallow, she can’t breathe, she is on a Rollator walker at home and a transport chair away from home. I have to do everything for her, which causes even more pain in my back.
I never got high or addicted to Hydrocodone. I need more than 2 a day to manage my pain. The lack of it is going to cause the pain to kill me, no matter what your expose was communicated to the Public via Channel 13.

So you tell me how to solve my problem. Maybe the answer is in a dumpster somewhere.

Sincerely,

1Lt H Terry Sanders, US Army
901 Solomon Drive
Franklin, IN 46131-2581
Home: 317-736-9234
Cell: 317-696-2235
Email: terry12633@comcast.net

Veterans for Medical Cannabis Access

November 2013 article and video with veteran Michael Krawitz:

[i]During his fight, Krawitz found other veterans and allies in the medical cannabis community and formed Veterans for Medical Cannabis Access (VMCA) in 2007. Together they continued to work with administrators at the VA until, finally, on January 31, 2011, the VA issued directive 2011-004, “Access to Clinical Programs for Veterans Participating in State-Approved Marijuana Programs”…[/i]

http://blog.sfgate.com/smellthetruth/2013/11/11/mmj-for-vets-legalization-offers-best-access-of-all/

PTSD Symptom Reports of Patients Evaluated for the NM Medical Cannabis Program

http://www.tandfonline.com/doi/abs/10.1080/02791072.2013.873843#preview

March 11, 2014

Abstract

Background: New Mexico was the first state to list post-traumatic stress disorder (PTSD) as a condition for the use of medical cannabis. There are no published studies, other than case reports, of the effects of cannabis on PTSD symptoms. The purpose of the study was to report and statistically analyze psychometric data on PTSD symptoms collected during 80 psychiatric evaluations of patients applying to the New Mexico Medical Cannabis Program from 2009 to 2011.

Methods: The Clinician Administered Posttraumatic Scale for DSM-IV (CAPS) was administered retrospectively and symptom scores were then collected and compared in a retrospective chart review of the first 80 patients evaluated. Results: Greater than 75% reduction in CAPS symptom scores were reported when patients were using cannabis compared to when they were not. Conclusions: Cannabis is associated with reductions in PTSD symptoms in some patients, and prospective, placebo-controlled study is needed to determine efficacy of cannabis and its constituents in treating PTSD.

Military: Transformation of Pain Management (2013)

National RX Drug Abuse Summit
Orland, FL
April 2-4, 2013
nationalrxdrugabusesummit.org

Military: Transformation of Pain Management
Royal Dublin A & B

The Department of Defense (DoD) and Veterans Affairs (VA) share an interest in addressing the overuse, misuse, abuse, and diversion of prescription medications by service members and veterans. The DoD/VA Pain Management Task Force Report (2010) provided the rationale and recommendations to transform current pain management practice towards a more patient centered and holistic approach. Two initiatives that exemplify the DoD/VA transformation of pain management include: PASTOR/PROMIS and Project ECHO. First, a patient reported outcomes initiative that will allow the military to move beyond “chasing zero” for pain management treatment goal to improving function and quality of life. PASTOR/PROMIS leverages the NIH PROMIS initiative to provide statistically significant data and clinical decision making information.

Second, developed at University of New Mexico, Project ECHO is a “tele-mentoring” initiative
that has been adapted for use in DoD and VA to build competence and confidence of primary
care providers to address the pain management needs of Service members and Veterans.

Military Workshop: Beyond Medications: Military Medicine’s Expansion of Pain
Management Treatment Options

Moderator: Col. Kevin Galloway, Chief of Staff, U.S. Army Pain Management Task Force
Presenter: Col. Richard Petri, Director, Department of Defense’s Center for Integrative Medicine
and the Interdisciplinary Pain Management Center, William Beaumont Army Medical Center

The Department of Defense and Veterans Health Administration are facing unique challenges to
pain management tactics that are not always easy to solve. Through the use of the U.S. Army
Pain Management Task Force, new initiatives are underway to overcome limitations and bring
about new approaches to medicine. In this session, you will hear many treatment options that
are being utilized in the U.S. Military and learn how to apply them in civilian medicine.

Learning Objectives:
1. Outline strategies to provide community level support to soldiers and their families struggling with prescription pain addiction.
2. Plan how to establish a support group for spouses and children of military families.
3. Identify ways to leverage partnerships to impact your community.

Letter from Veterans Affairs, opioid treatment and MMJ (2010)

Department of Veterans Affairs
Under Secretary for Health
Washington, DC 20420

July 6, 2010

Mr. Michael Krawitz
3551 Flatwoods Road
Elliston, VA 24087

Dear Mr. Krawitz:

This is a follow-up response to your letter requesting clarification of the Veterans Health Administration’s (VHA) policy regarding the practice of prescribing opioid therapy for pain management for Veterans who provide documentation of the use of medical marijuana in accordance with state law.

If a Veteran obtains and uses medical marijuana in a manner consistent with state law, testing positive for marijuana would not preclude the Veteran from receiving opioids for pain management in a Department of Veterans Affairs (VA) facility. The Veteran would need to inform his provider of the use of medical marijuana, and of any other non-VA prescribed medications he or she is taking to ensure that all medications, including opioids, are prescribed in a safe manner. Standard pain management agreements should draw a clear distinction between the use of illegal drugs, and legal medical marijuana. However, the discretion to prescribe, or not prescribe, opioids in conjunction with medical marijuana, should be determined on clinical grounds, and thus will remain the decision of the individual health care provider. The provider will take the use of medical marijuana into account in all prescribing decisions, just as the provider would for any other medication. This is a case-by-case decision, based upon the provider’s judgment, and the needs of the patient.

Should you have further questions, please contact Robert Kerns, PhD, National Program Director, New England Healthcare System at (203) 932-5711, extension 3841.

Sincerely,

Robert A. Petzel, M.D.
Original letter on Department of Veterans Affairs letterhead; retyped from pdf file created February 7, 2013, entitled “Post-Traumatic Stress Disorder And The Oregon Medical Marijuana Program, An overview of research and testimony regarding Post-Traumatic Stress Disorder and the use of medical marijuana to treat symptoms.”

4/19/2014, Marijuana helping troops who suffer from PTSD

http://www.khou.com/news/health/Marijuana-helping-troops-who-suffer-from-PTSD–246189001.html

The 26-year-old combat veteran served in the Army from 2009 to 2011. During that time, he says two men in his unit committed suicide.

“That’s the hardest part. You’re here and you have a chance to survive, and yet you take that chance to zero,” he said.

When he returned to his hometown, his girlfriend at the time noticed he had symptoms of Post Traumatic Stress Disorder or PTSD.

“She was like, ‘Hey, sometimes you get paranoid. Sometimes you get angry. Sometimes you get frustrated really easy,’” said the soldier his voice breaking up.

“And it’s hard to hear that you do that. It makes you feel like a monster,” he said.

The soldier found relief in New Mexico, one of only five states with medical marijuana programs that include PTSD among the treatable conditions.

“And a lot of vets moved here for that very reason, so they can be in the program,” said Hilda Chavez, a naturopath and patient advocate.

Chavez helps doctors screen patients and works with those who qualify. She and the doctors require PTSD patients who want to use medical marijuana to also get counseling.

She teaches veterans which strain is best for their condition and methods of using medical marijuana that go beyond smoking.

“We have been told consistently by most of the vets that they were over-medicated with drugs that were making them sleep all day or making them more anxious, and they would lose control of their lives,” said Chavez.

The young veteran from New Mexico was reluctant to take prescription drugs after he saw their effect on his older sister, another veteran suffering with PTSD.

“You’d ask her to get something and it was almost like she was doing it in slow motion. And sometimes she’d slur like she was drunk but she wasn’t.  She was just on the pain meds,” said the soldier.

She was addicted to the medication, he said.

“She took a nap one day and just didn’t wake up,” remembered the soldier.

His sister was 30 years old when she died.

Several veterans’ organizations are urging the federal government to allow veterans to use medical marijuana, including Veterans for Medical Cannabis Access. The group “advocates for safe and legal access to cannabis (marijuana) for all appropriate therapeutic uses.”

The organization and others also want research on the use of medical marijuana as a treatment alternative for PTSD and other conditions.

The organization Veterans for Compassionate Care says, “Marijuana politics blunt effort to ease PTSD” on its website. The organization also wants “a professionally controlled and monitored study program focusing on veterans’ treatment for PTSD.”

Veterans Affairs declined a request for an interview but in an emailed statement said: “Marijuana remains illegal according to federal law. Department of Veterans Affairs (VA) providers do not participate in medical marijuana programs even in states that have made it legal.”

But according to the VA, the policy does not prevent veterans who are using medical marijuana from seeking treatment at VA facilities where “the use of marijuana is taken into account when prescribing medications and planning treatment.”

The young vet from the small town in New Mexico who is using medical marijuana is getting counseling at the VA.

Please help

My comment posted at:
http://www.pharmaciststeve.com/?p=7827

Painkills2 Your comment is awaiting moderation.
November 26th, 2014 at 18:16

The pain patient who committed suicide (mentioned in the linked article) died in 2012, and when I did a google search for her name, I didn’t find that her death had ever been reported. It seems that this article from September, 2014 is the first mention of her 2012 tragic death.

http://www.tampabay.com/news/health/prescription-painkiller-crackdown-has-gone-way-too-far-some-doctors-believe/2195678#comments

I’m going to begin posting any mentions of pain patients who were driven to suicide at my blog. I would really appreciate it if others would help me in this effort and let me know where to find any more articles to post.

https://painkills2.wordpress.com/category/suicide/

What Do Washington State Marijuana DUI Numbers Tell Us?

http://www.hightimes.com/read/what-do-washington-state-marijuana-dui-numbers-tell-us

I wonder how medical cannabis patients in Washington (and Colorado) handle being “caught” driving at or over the 5ng THC limit.  How does any patient handle having their driver’s license taken away and being unable to drive?  I wouldn’t be able to function without transportation.

As the article below indicates, the 5ng limit is ridiculously low:

http://www.mensjournal.com/magazine/the-nfls-pot-problem-20140919

While Major League Baseball, and even the U.S. military, allow a limit of 50 ng/ml (nanogram per milliliter) of THC (marijuana’s active ingredient) in urine, the NFL’s new policy sets the limit at 35 ng/ml, up from a threshold of just 15 ng/ml during the last three decades…

Just how much pot a player has to ingest to meet that threshold varies depending on his weight, body fat, and metabolism, but a general rule of thumb is that if you smoked marijuana only once, detectable levels (50 ng/ml) would remain in your system for five to eight days; a near-daily smoker would show levels of 50 ng/ml or more for 33 to 48 days afterward.